cryotherapy means ice therapy is made up of ice and used in the treatment of an acute injury and gives instant relief to the patient with the condition going in the depth then everyone knows cryotherapy

1. CRYOTHERAPY
DR.NEHA PT
MPT NEUROLOGY

2. CRYOTHERAPY
• The application of cold for various therapeutic purposes is called cryotherapy.
• It is commonly used in the treatment of acute trauma and subacute injury.
• The temperature of the body tissue is reduced and the heat is transferred from the
body tissue to the cold medium.
• The magnitude of cooling depends upon the area of the body tissue exposed,
temperature of the cooling agent and the duration of exposure.

3. Cont.
• The depth of penetration is also related to intensity and duration of cold
application and the circulatory response to the body segment exposed.
• A constant source of cooling , the temperature drop the tissue will depend
upon
1. The temperature difference between the coolant and the tissues; the colder
the application, the greater the heat loss from the tissues.

4. • The length of time for which the cold is applied ,the amount of energy loss is fully
dependent upon the length of exposure.
• The size of area that is being cooled ,the smaller the area ,more will be cooling .
• Ice massage, ice towels , immersion in the cold etc.
• Evaporative coolant or vapocoolant sprays (fluromethane or ethyl chloride) jet of
sprays usually applied from a distance of about 1 feet or 12 inches. Gentle stretch is
applied to the tissues after application of vapocoolant sprays.

5. EXCITATORY COLD
• The marked sensory stimulus of ice on the skin can be used to facilitate
contraction of inhibited muscle , a certain the spinal root level supply
myotome of inhibited muscles and find the area of skin which has same
root supply (dermatome).
• The ice is stroked quickly three times over the dermatome and the skin is
then dried .the sensory stimulus passes via the peripheral nerve and enters
the cord through posterior horn.it raises the level of excitation around the
anterior horn cells (as ACH has connection with these sensory fibers).

6. CONT.
• The technique of quick ice is often a useful stimulus in aiding voluntary
contraction of muscle.

7. Basic Principles
• When cold therapy is applied to the tissues, the heat is absorbed from the
tissue by the cooling agents. Ice changes from a solid to a liquid by absorbing
heat. a specific amount of energy is required to change the solid form of ice
into water which is called the latent heat of fusion.
• 1 gram of ice at 0degree Celsius requires 155 joules of energy to convert it
into 1 gram of water at 37 degree c, thus for cooling the body tissues it is
better to use ice for treatment rather than water.

8. Physiological effects
• The initial response of the body tissue to cold is that to preserve the heat.
this is accomplished by initial phase of local vaso-constriction. when
homeostasis is reached and the body part has become cooled ,there follows
phase of vasodilation. This appears as hunting toward the mean point and is
known as Lewis –Hunting reaction.
• The initial phase of vasoconstriction helps to reduce the flow of blood into
the tissues following recent injury. this helps to limit swelling and the extent
of tissue damage .

11. Effects on Nervous System.
• The rate of conduction of the fibers is reduced by cold. The a fibers are
affected first by b &c fibers.
• The major effects of ice application are to relieve pain. The probable
mechanism involved is the stimulation of cold receptors which send back the
impulses which have to pass the spinal cord via the posterior root these
impulses which arrives through the relatively large diameter nerves effectively
block the pain impulses attempting to gain access to the cord and thus pain
gate is closed.

12. Dangers & Contraindication.
• Cardiac condition:- it need special attention.in patient with a recent MI ,the
application of cold may cause further drop in blood pressure and further
reduces blood supply of the heart ,the weak heart may collapse immediately .
• Peripheral nerve injuries: In cases with peripheral nerve injuries the blood
supply of peripheral nerve reduces further may cause damage ,also nerve
supply of the blood vessels is further delayed causing loss of normal
response of its cooling. application of cold should be avoided

13. Cont.
• Peripheral vascular disease or vaso-spastic disease : the application of cold should
be avoided in cases of peripheral vascular disease ,the cord may further reduces an
already inadequate blood supply. In cases of vasospastic disease like the Raynaud`s
disease, the condition may worsen by the application of cold.
• Psychological or cold sensitive ;- the patient have fear of the cold may react
adversely. following the application of cold ,they start producing histamine like
substance causing urticarial with skin rash & itching. the application of cold in
psychological apprehensive person and the cold sensitive person is avoided.

14. ASSESSMENT
• Receiving patient
• History (demographic details)
• Chief complaints
• General contraindication(HTN)
• Local contraindication
• Preparation of trays
• Preparation of the cold packs
• Positioning of patient

15. • Preparation of Pt
• Application of Pt
• Termination(inspection)
• Records
• Knowledge of dangers
• Home instruction
• General information
• Treatment time 15 min after a interval of 10 minutes.